JP2014514079A5 - - Google Patents
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- JP2014514079A5 JP2014514079A5 JP2014504394A JP2014504394A JP2014514079A5 JP 2014514079 A5 JP2014514079 A5 JP 2014514079A5 JP 2014504394 A JP2014504394 A JP 2014504394A JP 2014504394 A JP2014504394 A JP 2014504394A JP 2014514079 A5 JP2014514079 A5 JP 2014514079A5
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- Prior art keywords
- expandable membrane
- degrees celsius
- item
- temperature
- refrigerant
- Prior art date
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- 239000012528 membrane Substances 0.000 claims description 47
- 239000003507 refrigerant Substances 0.000 claims description 21
- 210000004204 Blood Vessels Anatomy 0.000 claims description 19
- 238000001816 cooling Methods 0.000 claims description 10
- 239000007788 liquid Substances 0.000 claims description 8
- 239000012530 fluid Substances 0.000 claims description 7
- TXEYQDLBPFQVAA-UHFFFAOYSA-N Tetrafluoromethane Chemical compound FC(F)(F)F TXEYQDLBPFQVAA-UHFFFAOYSA-N 0.000 claims description 2
- 238000009835 boiling Methods 0.000 claims description 2
- 239000002826 coolant Substances 0.000 claims description 2
- 238000007710 freezing Methods 0.000 claims description 2
- 239000000203 mixture Substances 0.000 claims description 2
- 241000282320 Panthera leo Species 0.000 claims 1
- 239000002356 single layer Substances 0.000 claims 1
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 5
- NLXLAEXVIDQMFP-UHFFFAOYSA-N Ammonium chloride Substances [NH4+].[Cl-] NLXLAEXVIDQMFP-UHFFFAOYSA-N 0.000 description 3
- 235000019270 ammonium chloride Nutrition 0.000 description 3
- QDHHCQZDFGDHMP-UHFFFAOYSA-N monochloramine Chemical compound ClN QDHHCQZDFGDHMP-UHFFFAOYSA-N 0.000 description 3
- FYSNRJHAOHDILO-UHFFFAOYSA-N Thionyl chloride Chemical compound ClS(Cl)=O FYSNRJHAOHDILO-UHFFFAOYSA-N 0.000 description 2
- QTBSBXVTEAMEQO-UHFFFAOYSA-N acetic acid Chemical compound CC(O)=O QTBSBXVTEAMEQO-UHFFFAOYSA-N 0.000 description 2
- 238000003384 imaging method Methods 0.000 description 2
- 239000000463 material Substances 0.000 description 2
- 238000000034 method Methods 0.000 description 2
- WCUXLLCKKVVCTQ-UHFFFAOYSA-M potassium chloride Chemical compound [Cl-].[K+] WCUXLLCKKVVCTQ-UHFFFAOYSA-M 0.000 description 2
- CDBYLPFSWZWCQE-UHFFFAOYSA-L sodium carbonate Chemical compound [Na+].[Na+].[O-]C([O-])=O CDBYLPFSWZWCQE-UHFFFAOYSA-L 0.000 description 2
- 229960000583 Acetic Acid Drugs 0.000 description 1
- DVARTQFDIMZBAA-UHFFFAOYSA-O Ammonium nitrate Chemical compound [NH4+].[O-][N+]([O-])=O DVARTQFDIMZBAA-UHFFFAOYSA-O 0.000 description 1
- SOIFLUNRINLCBN-UHFFFAOYSA-N Ammonium thiocyanate Chemical compound [NH4+].[S-]C#N SOIFLUNRINLCBN-UHFFFAOYSA-N 0.000 description 1
- 102000008186 Collagen Human genes 0.000 description 1
- 108010035532 Collagen Proteins 0.000 description 1
- 235000011054 acetic acid Nutrition 0.000 description 1
- ZUDYPQRUOYEARG-UHFFFAOYSA-L barium(2+);dihydroxide;octahydrate Chemical compound O.O.O.O.O.O.O.O.[OH-].[OH-].[Ba+2] ZUDYPQRUOYEARG-UHFFFAOYSA-L 0.000 description 1
- MEYVLGVRTYSQHI-UHFFFAOYSA-L cobalt(2+);sulfate;heptahydrate Chemical compound O.O.O.O.O.O.O.[Co+2].[O-]S([O-])(=O)=O MEYVLGVRTYSQHI-UHFFFAOYSA-L 0.000 description 1
- 229960005188 collagen Drugs 0.000 description 1
- 229920001436 collagen Polymers 0.000 description 1
- 150000001875 compounds Chemical class 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 239000001103 potassium chloride Substances 0.000 description 1
- 235000011164 potassium chloride Nutrition 0.000 description 1
- 239000001187 sodium carbonate Substances 0.000 description 1
- 229910000029 sodium carbonate Inorganic materials 0.000 description 1
- 230000000087 stabilizing Effects 0.000 description 1
- 239000000725 suspension Substances 0.000 description 1
Description
明細書及びここに記載されている実施形態の実施を考慮して、当業者には本発明の他の実施形態も明らかであろう。明細書及び例示は、あくまで例として支援されており、本発明の真の範囲及び精神は、以下の請求項に示されている。加えて、本願において特定の順序の方法またはプロシージャの段階をリストしている場合であっても、状況によっては、いくつかの段階を行う順序を変更することができたり、変更するほうが望ましかったりする場合もあり、以下に述べる方法またはプロシージャの請求項の特定の段階は、その順序の特異性が請求項で明示されていない限り、順序が重要であるとして解釈されるべきではない。
なお、本願明細書に記載の実施形態によれば、以下の構成もまた開示される。
[項目1]
拡張可能な膜を有するカテーテル装置と、
前記拡張可能な膜の拡張を調整して、前記拡張可能な膜が、5ATM(507kPa)未満の圧力で拡張するようにする、圧力制御システムと、
前記カテーテル装置が血管に配置されたとき、前記拡張可能な膜と前記血管との界面に、摂氏+15度(288K)及び摂氏−35度(238K)の間の温度を構築する冷却部材と
を備える、システム。
[項目2]
前記冷却部材が、冷媒、吸熱反応コンポーネント、熱電クーラー、及び、これらの組み合わせからなる群から選択される、項目1に記載のシステム。
[項目3]
温度を監視して、前記冷却部材を調節して、摂氏+15度(288K)及び摂氏−35度(238K)の間の前記界面の温度を維持する温度制御システムをさらに備える、項目1または2に記載のシステム。
[項目4]
前記拡張可能な膜は、流体を含むよう構成されており、
前記システムはさらに、前記拡張可能な膜に流体を供給する流体源を備え、
前記圧力制御システムは、前記流体源の圧力を調節して、前記拡張可能な膜が、5ATM(507kPa)未満の圧力で拡張されるようにする、項目1から3のいずれか一項に記載のシステム。
[項目5]
前記拡張可能な膜と流体貯蔵部との間の戻りラインに配置された真空ポンプをさらに備える、項目4に記載のシステム。
[項目6]
前記流体源からの別個の冷媒ラインによって冷媒供給ラインを冷却する接続装置をさらに備える、項目4に記載のシステム。
[項目7]
血管内のプラークにクライオエネルギーを供給する方法であって、
前記血管内の前記プラークに熱接触するよう配置されていたカテーテル装置の拡張可能な膜を、5ATM(507kPa)未満の圧力で拡張する段階と、
前記拡張可能な膜と前記血管との界面で、摂氏+15度(288K)及び摂氏−35度(238K)の間の温度を構築する段階と
を備える方法。
[項目8]
血管内のプラークの構造を修正する方法であって、
カテーテル装置を、前記血管内の前記プラークに近接する位置に配置する段階と、
前記カテーテル装置の拡張可能な膜を、5ATM(507kPa)未満の圧力で拡張する段階と、
前記拡張可能な膜と前記血管との間の界面で、摂氏+15度(288K)及び摂氏−35度(238K)の間の温度を構築する段階と
を備える方法。
[項目9]
前記カテーテル装置は、単一の拡張可能な膜を有する、項目7に記載の方法。
[項目10]
前記拡張可能な膜は、前記血管に適応する、項目7から9のいずれか一項に記載の方法。
[項目11]
前記拡張可能な膜は、前記血管に半適応する、項目7から9のいずれか一項に記載の方法。
[項目12]
前記拡張可能な膜は、前記血管に適応しない、項目7から9のいずれか一項に記載の方法。
[項目13]
前記拡張可能な膜は、実質的にスムーズな外表面を有している、項目7から12のいずれか一項に記載の方法。
[項目14]
前記カテーテル装置に設けられたセンサを利用して、拡張可能な膜特性を判断する段階をさらに備える、項目7から13のいずれか一項に記載の方法。
[項目15]
前記カテーテル装置を撮像する段階をさらに備え、
前記拡張可能な膜は、放射線不透性物質を含む、項目7から14のいずれか一項に記載の方法。
[項目16]
前記拡張可能な膜は、4ATM(405kPa)未満の圧力で拡張される、項目7から15のいずれか一項に記載の方法。
[項目17]
前記拡張可能な膜は、3ATM(304kPa)未満の圧力で拡張される、項目16に記載の方法。
[項目18]
前記拡張可能な膜は、2ATM(203kPa)未満の圧力で拡張される、項目17に記載の方法。
[項目19]
前記拡張可能な膜は、1ATM(101kPa)未満の圧力、または、1ATM(101kPa)に略等しい圧力で拡張される、項目18に記載の方法。
[項目20]
前記拡張可能な膜は、冷媒を含み、
前記温度を構築する段階は、
前記拡張可能な膜に冷媒を供給する段階を含む、項目7から19のいずれか一項に記載の方法。
[項目21]
前記拡張可能な膜の内部の冷媒は、液状に保たれる、項目20に記載の方法。
[項目22]
前記冷媒は、大気圧で摂氏+37度(310K)を超える沸点と、大気圧で摂氏−85度(358K)未満の氷点とを持ち、摂氏−85度(188K)で、10cSt(10×10 −6 m 2 /s)未満の動的粘度を持つ、項目21に記載の方法。
[項目23]
前記拡張可能な膜の内部の冷媒は、摂氏−25度(248K)及び摂氏−55度(218K)の間の温度に維持される、項目20から22のいずれか一項に記載の方法。
[項目24]
前記冷媒は、パーフルオロカーボンを含む、項目20から23のいずれか一項に記載の方法。
[項目25]
前記カテーテル装置に設けられたセンサを利用して、冷媒特性を判断する段階をさらに備える、項目20から24のいずれか一項に記載の方法。
[項目26]
前記冷媒を撮像する段階をさらに備え、
前記冷媒は、放射線不透性物質を含む、項目20から25のいずれか一項に記載の方法。
[項目27]
前記温度を構築する段階は、
吸熱反応を生じさせる段階を含む、項目7または8に記載の方法。
[項目28]
前記吸熱反応は、前記拡張可能な膜を加圧することで生じる、項目27に記載の方法。
[項目29]
前記吸熱反応は、前記拡張可能な膜を拡張することで生じる、項目27に記載の方法。
[項目30]
前記吸熱反応は、水と硝酸アンモニウム、水と塩化アンモニウム、水酸化バリウム八水和物の結晶及び乾燥塩化アンモニウム、水と塩化アンモニウム、塩化チオニルと硫酸コバルト(II)七水和物、水と塩化カリウム、水とチオシアン酸アンモニウム、及び、エタン酸と炭酸ナトリウムを含む化合物の対のうちの1以上の間の反応である、項目27に記載の方法。
[項目31]
前記拡張可能な膜の内部の温度は、前記拡張可能な膜に近接した位置の冷却部材により維持される、項目7または8に記載の方法。
[項目32]
前記冷却部材は、熱電冷却部材を含む、項目31に記載の方法。
[項目33]
前記冷却部材は、ペルチェコンポーネントを含む、項目32に記載の方法。
[項目34]
前記カテーテル装置に設けられた温度センサを利用して、前記血管の詰りの状態を判断する段階をさらに備える、項目7から33のいずれか一項に記載の方法。
[項目35]
図面を参照して示した脆弱なプラークを処置するカテーテル装置。
[項目36]
図面を参照して示した脆弱なプラークを処置するシステム。
[項目37]
図面を参照して示した脆弱なプラークを処置する方法。
[項目38]
血管内のプラークに、5ATM(507kPa)未満の圧力まで、且つ、内表面の血管に、摂氏+15度(288K)及び摂氏−35度(238K)の間の温度にまで、クライオエネルギーを供給して、コラーゲンのレベルを増加させ、前記プラークを安定させる、方法。
[項目39]
液体冷媒を利用するクライオ医療冷媒システム(cryomedical refrigerant system)であって、
前記液体は懸濁液に気泡が吹き込まれたものであり、
前記気泡は、熱伝達部内で拡張してはじけ、前記液体冷媒内でジュールトムソン効果による冷却を行う、クライオ医療冷媒システム。
Other embodiments of the invention will be apparent to those skilled in the art from consideration of the specification and practice of the embodiments described herein. The specification and illustrations are provided as examples only, with the true scope and spirit of the invention being indicated in the following claims. In addition, even if a particular order of method or procedure steps is listed in this application, depending on the situation, the order in which several steps are performed may or may be desirable to change. In particular, certain steps in a method or procedure claim set forth below should not be construed as critical unless the specificity of the order is explicitly stated in the claim.
In addition, according to embodiment described in this-application specification, the following structures are also disclosed.
[Item 1]
A catheter device having an expandable membrane;
A pressure control system that adjusts the expansion of the expandable membrane such that the expandable membrane expands at a pressure of less than 5 ATM (507 kPa);
A cooling member that builds a temperature between +15 degrees Celsius (288K) and -35 degrees Celsius (238K) at the interface between the expandable membrane and the blood vessel when the catheter device is placed in a blood vessel;
A system comprising:
[Item 2]
The system according to item 1, wherein the cooling member is selected from the group consisting of a refrigerant, an endothermic reaction component, a thermoelectric cooler, and combinations thereof.
[Item 3]
Item 1 or 2, further comprising a temperature control system that monitors temperature and adjusts the cooling member to maintain the temperature of the interface between +15 degrees Celsius (288K) and -35 degrees Celsius (238K) The described system.
[Item 4]
The expandable membrane is configured to contain a fluid;
The system further comprises a fluid source for supplying fluid to the expandable membrane;
4. The pressure control system according to any one of items 1 to 3, wherein the pressure control system adjusts the pressure of the fluid source so that the expandable membrane is expanded at a pressure of less than 5 ATM (507 kPa). system.
[Item 5]
5. The system of item 4, further comprising a vacuum pump disposed in a return line between the expandable membrane and a fluid reservoir.
[Item 6]
5. The system of item 4, further comprising a connection device that cools a refrigerant supply line by a separate refrigerant line from the fluid source.
[Item 7]
A method of supplying cryoenergy to plaque in a blood vessel,
Expanding the expandable membrane of the catheter device that was placed in thermal contact with the plaque in the blood vessel with a pressure of less than 5 ATM (507 kPa);
Constructing a temperature between +15 degrees Celsius (288K) and -35 degrees Celsius (238K) at the interface between the expandable membrane and the blood vessel;
A method comprising:
[Item 8]
A method for modifying the structure of plaque in a blood vessel,
Placing a catheter device at a location in the blood vessel close to the plaque;
Expanding the expandable membrane of the catheter device with a pressure of less than 5 ATM (507 kPa);
Building a temperature between +15 degrees Celsius (288K) and -35 degrees Celsius (238K) at the interface between the expandable membrane and the blood vessel;
A method comprising:
[Item 9]
8. The method of item 7, wherein the catheter device has a single expandable membrane.
[Item 10]
10. A method according to any one of items 7 to 9, wherein the expandable membrane is adapted to the blood vessel.
[Item 11]
10. A method according to any one of items 7 to 9, wherein the expandable membrane is semi-adapted to the blood vessel.
[Item 12]
10. A method according to any one of items 7 to 9, wherein the expandable membrane does not adapt to the blood vessel.
[Item 13]
13. A method according to any one of items 7 to 12, wherein the expandable membrane has a substantially smooth outer surface.
[Item 14]
14. A method according to any one of items 7 to 13, further comprising determining expandable membrane properties using a sensor provided on the catheter device.
[Item 15]
Further comprising imaging the catheter device;
15. A method according to any one of items 7 to 14, wherein the expandable membrane comprises a radiopaque material.
[Item 16]
16. A method according to any one of items 7 to 15, wherein the expandable membrane is expanded at a pressure of less than 4 ATM (405 kPa).
[Item 17]
The method of item 16, wherein the expandable membrane is expanded at a pressure of less than 3 ATM (304 kPa).
[Item 18]
18. The method of item 17, wherein the expandable membrane is expanded at a pressure of less than 2 ATM (203 kPa).
[Item 19]
19. The method of item 18, wherein the expandable membrane is expanded at a pressure of less than 1 ATM (101 kPa) or approximately equal to 1 ATM (101 kPa).
[Item 20]
The expandable membrane includes a refrigerant;
Building the temperature comprises:
20. A method according to any one of items 7 to 19, comprising supplying a coolant to the expandable membrane.
[Item 21]
21. A method according to item 20, wherein the refrigerant inside the expandable membrane is kept in a liquid state.
[Item 22]
The refrigerant has a boiling point above + 37 ° C (310K) at atmospheric pressure, has a freezing point of less than -85 degrees Celsius (358K) at atmospheric pressure, at -85 ° C (188K), 10cSt (10 × 10 - Item 22. The method according to Item 21, wherein the method has a dynamic viscosity of less than 6 m 2 / s).
[Item 23]
23. The method of any one of items 20 to 22, wherein the refrigerant inside the expandable membrane is maintained at a temperature between -25 degrees Celsius (248K) and -55 degrees Celsius (218K).
[Item 24]
24. A method according to any one of items 20 to 23, wherein the refrigerant comprises perfluorocarbon.
[Item 25]
25. A method according to any one of items 20 to 24, further comprising the step of determining refrigerant characteristics using a sensor provided in the catheter device.
[Item 26]
Further comprising imaging the refrigerant,
26. A method according to any one of items 20 to 25, wherein the refrigerant comprises a radiopaque material.
[Item 27]
Building the temperature comprises:
Item 9. The method according to Item 7 or 8, comprising a step of causing an endothermic reaction.
[Item 28]
28. The method of item 27, wherein the endothermic reaction occurs by pressurizing the expandable membrane.
[Item 29]
28. The method of item 27, wherein the endothermic reaction occurs by expanding the expandable membrane.
[Item 30]
The endothermic reaction consists of water and ammonium nitrate, water and ammonium chloride, barium hydroxide octahydrate crystals and dry ammonium chloride, water and ammonium chloride, thionyl chloride and cobalt (II) sulfate heptahydrate, water and potassium chloride. 28. The method of item 27, wherein the reaction is between one or more of a pair of compounds comprising water and ammonium thiocyanate and ethanoic acid and sodium carbonate.
[Item 31]
9. A method according to item 7 or 8, wherein the temperature inside the expandable membrane is maintained by a cooling member in a position proximate to the expandable membrane.
[Item 32]
32. The method of item 31, wherein the cooling member comprises a thermoelectric cooling member.
[Item 33]
33. A method according to item 32, wherein the cooling member comprises a Peltier component.
[Item 34]
34. A method according to any one of items 7 to 33, further comprising determining a clogged state of the blood vessel using a temperature sensor provided in the catheter device.
[Item 35]
The catheter apparatus which treats the vulnerable plaque shown with reference to drawings.
[Item 36]
A system for treating vulnerable plaque shown with reference to the drawings.
[Item 37]
A method of treating vulnerable plaque shown with reference to the drawings.
[Item 38]
Apply cryoenergy to plaques in blood vessels to pressures below 5 ATM (507 kPa) and to blood vessels on the inner surface to temperatures between +15 degrees Celsius (288K) and -35 degrees Celsius (238K). Increasing the level of collagen and stabilizing the plaque.
[Item 39]
A cryomedical refrigerant system that uses liquid refrigerant,
The liquid is one in which bubbles are blown into the suspension,
The cryomedical refrigerant system in which the bubbles are expanded and repelled in a heat transfer unit, and are cooled by the Joule-Thompson effect in the liquid refrigerant.
Claims (16)
液体で前記拡張可能な膜の拡張を調整して、前記拡張可能な膜が、5ATM(507kPa)未満の圧力の前記液体で拡張するようにする、圧力制御システムと、
前記カテーテル装置が血管に配置されたとき、前記拡張可能な膜と前記血管との界面に、摂氏+15度(288K)及び摂氏−35度(238K)の間の温度を構築する冷却部材と
前記界面の温度を監視して、前記冷却部材を調節して、摂氏+15度(288K)及び摂氏−35度(238K)の間の前記界面の温度を維持する温度制御システムと
を備える、システム。 A catheter device having a single expandable membrane;
A pressure control system for adjusting expansion of the expandable membrane with a liquid so that the expandable membrane expands with the liquid at a pressure of less than 5 ATM (507 kPa);
A cooling member that builds a temperature between +15 degrees Celsius (288K) and -35 degrees Celsius (238K) at the interface between the expandable membrane and the blood vessel when the catheter device is placed in a blood vessel;
A temperature control system that monitors the interface temperature and adjusts the cooling member to maintain the interface temperature between +15 degrees Celsius (288K) and -35 degrees Celsius (238K) .
カテーテル装置の拡張可能な単一の膜を、液体を利用して5ATM(507kPa)未満の圧力まで拡張する段階と、
前記拡張可能な膜において、摂氏+15度(288K)及び摂氏−35度(238K)の間の温度を構築する段階と
を備える方法。 A method of operating a system for supplying click Lion energy,
Expandable single layer of catheters device, the method comprising: expanding at a pressure less than 5ATM (507 kPa) or by using a liquid,
Building a temperature between +15 degrees Celsius (288K) and -35 degrees Celsius (238K) in the expandable membrane .
温度を構築する前記段階は、
前記拡張可能な膜に冷媒を供給する段階を含む、請求項8から11のいずれか一項に記載の方法。 The expandable membrane includes a refrigerant;
Said step of constructing the temperature is
12. A method according to any one of claims 8 to 11 comprising supplying a coolant to the expandable membrane.
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US201161474987P | 2011-04-13 | 2011-04-13 | |
US61/474,987 | 2011-04-13 | ||
PCT/GB2012/050820 WO2012140439A1 (en) | 2011-04-13 | 2012-04-13 | Plaque stabilisation using cryoenergy |
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US11090100B2 (en) * | 2016-07-05 | 2021-08-17 | Biosense Webster (Israel) Ltd. | Catheter with micro-peltier cooling components |
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US20180280658A1 (en) * | 2017-04-03 | 2018-10-04 | Biosense Webster (Israel) Ltd. | Balloon catheter with ultrasonic transducers |
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CN111297549B (en) * | 2020-03-19 | 2022-03-08 | 中国人民解放军陆军特色医学中心 | Wound first aid ice bag convenient to carry and heat preservation storage facilities thereof |
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- 2012-04-13 CA CA2832803A patent/CA2832803C/en active Active
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- 2012-04-13 CN CN201280029205.1A patent/CN103781443B/en active Active
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